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FAMILIA Trial Teaches Healthy Habits at Early Age

Updated on Jun 30, 2022 | Community, Featured, Research

Natalia Leal and her son Gabriel are participants in FAMILIA, which instructs preschoolers and their families on cardiovascular health.

Children will listen. That is the simple premise underlying FAMILIA, a trial developed by Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital, to promote cardiovascular health among children while reducing their chances of developing risk factors for heart disease.

The “Family-Based Approach in a Minority Community Integrating Systems-Biology for Promotion of Health” (FAMILIA) trial enrolled 600 families in Harlem, including 562 children ages 3 to 5, over the last four years. It has demonstrated that a school-based education intervention is an effective strategy for instilling healthy behaviors among preschoolers, according to an abstract that Dr. Fuster presented in November 2018 at the American Heart Association Scientific Sessions in Chicago.

Dr. Fuster is a pioneer in the study of atherosclerotic disease—the build-up of fats, cholesterol, and other substances in and on artery walls—which is the leading cause of death in the United States. It develops slowly over a lifetime and is often caused by such factors as an unhealthy diet, lack of exercise, and tobacco use.

“There is good data showing that part of our behavior as adults develops between ages 3 and 5,” Dr. Fuster says. “If this age is so important, why wouldn’t we use this window of opportunity to teach children to make health a priority for the rest of their lives?”

Funded by a $3.8 million grant from the American Heart Association, FAMILIA is based on successful health interventions that Dr. Fuster developed in Bogota, Colombia, and Spain. Like those programs, FAMILIA is exploring how a child’s behavior, environment, and genetics may lead to heart disease, with the goal of reducing the future risk of obesity, heart attack, stroke, and type 2 diabetes by creating a family-based “culture of health.”

The specific objective of the FAMILIA trial was to “assess the impact of a preschool-based health promotion education intervention in an underserved community.” It enrolled children in 15 Head Start preschools, forming a cohort that was 51 percent female, 54 percent Hispanic/Latino, and 37 percent African American. Children were randomly assigned to either a control group that received their school’s normal curriculum or a group that received 50 hours of heart-health education over four months.

At the start, each child was interviewed by a team member with experience in early childhood education, using tools that were pictorial and structured like an interactive game. Based on the results, each child was given a KAH (knowledge, attitudes, and habits) score. The children who received intervention learned lessons, including: how the heart works; how to select healthy foods; how to regulate their emotions; and how to stay physically active and encourage their families to be active, too. After four months, researchers interviewed the preschoolers again and measured the change in KAH from the baseline.

Researchers found that the overall KAH score rose 11.8 percent from the baseline in the intervention group, compared with 5.5 percent in the control group. Based on the children’s responses, their attitudes about staying active and their understanding of the human body and heart were the biggest drivers of the higher KAH scores, researchers said. The team is planning to conduct a long-term follow-up at five and ten years to assess the sustainability of the intervention effects.

FAMILIA also includes a parallel program for the parents and caregivers of children in the trial. Some adults meet in small groups to help each other get healthier through peer support, while others receive individualized lifestyle counseling and a personal activity-monitoring device. Results from that program are expected in late 2019.

“What we are finding is a significant benefit in all respects,” Dr. Fuster says of both adults and children in FAMILIA. “Their knowledge, their attitudes, and their habits are quite positive, and this is very exciting.”

Icahn School of Medicine at Mount Sinai Creates New Position of Dean for Gender Equity in Science and Medicine

Updated on Jun 30, 2022 | Featured

Carol Horowitz, MD, MPH

The Icahn School of Medicine at Mount Sinai has created a new position, Dean for Gender Equity in Science and Medicine, to advance efforts to provide a supportive, collegial environment in which faculty, students, and trainees will succeed and feel valued without experiencing bias relating to their gender. Carol Horowitz, MD, MPH, a Professor of Population Health Science and Policy, has been named to the new position.

“Dr. Horowitz is a skilled physician-scientist who will bring passion, experience, and rigor to the role,” said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs at the Mount Sinai Health System. “She will be a visionary leader who will significantly impact the field both within and beyond Mount Sinai.”

The Icahn School of Medicine is among the first schools in the United States to elevate this role to a dean-level position.

Dr. Horowitz will interact with constituents to gather information on their experiences and perceptions. She will use this input to tackle a broad range of issues, including correcting possible inequities in compensation, hiring, promotion, and evaluation; raising awareness of and opportunities to promote equity; and working to eliminate bias throughout the Mount Sinai community.

Additionally, Dr. Horowitz will create an inventory of current programs and conduct needs assessments to identify intervention opportunities. She will develop and deploy programs that increase inclusiveness, thereby improving quality of life, recruitment, and retention across the Health System. Dr. Horowitz will also represent the Icahn School of Medicine externally, and will strive towards a national and international leadership role on initiatives that promote equity.

Dr. Horowitz joined the School of Medicine faculty in 1996. She is a Professor of Population Health Science and Policy with a secondary appointment in the Department of Medicine. She is also a member of the Mount Sinai Institute for Translational Epidemiology and The Charles Bronfman Institute for Personalized Medicine.

Dr. Horowitz conducts numerous National Institutes of Health-funded studies using stakeholder and community engagement to address health disparities, and she has more than 100 publications in leading medical journals. She co-founded and co-directs the Center for Health Equity and Community-Engaged Research within the School of Medicine and serves on the Health Care Disparities Task Force and the Social Determinants Steering Committee. Dr. Horowitz is a dedicated educator and mentor to junior faculty, students, and trainees. In addition to her research and education duties, she is a practicing general internist.

Dr. Horowitz is broadly recognized for her work. She lectures extensively and sits on multiple advisory boards at other academic institutions and professional societies. Her recent honors include the Lewis and Jack Rudin New York Prize for Medicine and Health and the Healthy Communities Promising Practice Award for her efforts in developing effective peer-led programs to prevent diabetes.

Dr. Horowitz earned her MD at Cornell University Medical College, now Weill Cornell Medicine. She completed an Internal Medicine internship and residency at the Albert Einstein College of Medicine. Dr. Horowitz received an MPH while a Robert Wood Johnson Clinical Scholars Fellow at the University of Washington in Seattle.

Advancing the Study of Dizziness and Imbalance

Updated on Jun 30, 2022 | Featured, School

Joanna C. Jen, MD, PhD, and Bernard Cohen, MD

Joanna C. Jen, MD, PhD, a physician-scientist with a special interest in the genetic and physiological basis of neurological disorders affecting eye movement control, balance, and coordination, recently joined the Icahn School of Medicine at Mount Sinai as Chief of the Division of Neuro-otology and Neurogenetics in the Department of Neurology.

She was named the Dr. Morris B. Bender Professor of Neurology, and Professor of Neurosurgery, and Otolaryngology, and will build upon the groundbreaking work of her predecessors—the late Morris B. Bender, MD, a pioneer in the neurology of the ocular motor system and a former Chair of Neurology at Mount Sinai, and Bernard Cohen, MD. An internationally renowned scientist and clinician, Dr. Cohen considerably advanced understanding of the functions of the vestibular system, helping to discover a mechanism in the brainstem that is an essential part of the neural basis for balance that aligns the body with gravity.

In one research project that began in the 1980s—which was recently documented in the Smithsonian Institution Online Virtual Archives Dr. Cohen was asked by NASA to test the neuro-optical response of primates when orbiting the Earth in microgravity. The Cosmos Primate Rotator Chair, which was built to specifications provided by Dr. Cohen and a Russian Academy of Medicine scientist, allowed the researchers to study eye movement responses in monkeys in an upright position and at various angles of tilt, before and after spaceflight. They demonstrated for the first time that exposure to microgravity had dramatically altered an essential reflex that is part of normal eye movements, both in humans and monkeys.

Dr. Cohen with the Cosmos Primate Rotator Chair.

The laboratory established by Dr. Cohen also developed the first effective treatment for mal de débarquement syndrome (MdDS), which has since treated more than 400 patients who have sensations of continuous rocking, swaying, and bobbing after cruises on the sea. Dr. Cohen, who served as the inaugural Dr. Morris B. Bender Professor of Neurology and continues his research as Professor Emeritus, recently provided generous funding for the first fellow in neuro-otology and for research on the pathophysiologic mechanisms underlying MdDS.

In her new role, Dr. Jen aims to create a comprehensive multidisciplinary clinical care and research program that spans the population health approach, from front-line evaluation and management of dizziness and imbalance, to precision medicine-based diagnosis and treatment for rare disorders of cerebellar maldevelopment and degeneration.

Computational Model Leads to Discovery of Gene-Activation Pathway Associated With Atherosclerosis

Updated on Jun 30, 2022 | Featured, Research

Jun Zhu, PhD

A computational model of cells that line blood vessels in the human heart, developed at the Icahn School of Medicine at Mount Sinai, has led to the discovery of a gene-activation pathway caused by lipids associated with coronary artery disease. The findings appear in the June 12, 2018, issue of Nature Communications.

The new pathway, discovered by researchers in Mount Sinai’s Department of Genetics and Genomic Sciences, and at Goethe University in Frankfurt, Germany, could help identify new directions in research and drug development.

Atherosclerosis is caused by the buildup of a complex mixture of components, commonly referred to as plaque, within the inner lining of arteries. Oxidized phospholipids are abundant in this arterial plaque and are thought to promote atherosclerosis progression. However, the specific cellular processes caused by these lipids on the arterial surface are still not well understood. The cells composing the inner surface of blood vessels, called endothelial cells, are at the forefront of the atherosclerotic process and, therefore, are a major focus of research into coronary artery disease.

“Computational biological models such as the one we used in this study are allowing us to uncover a wealth of knowledge about complex diseases that we never could before,” says Jun Zhu, PhD, Professor of Genetics and Genomic Sciences at the Icahn School of Medicine at Mount Sinai; Head of Data Science at Sema4, a patient-centered predictive health company that is a Mount Sinai venture; and co-senior author of the study. “Endothelial cell response to lipids has been studied extensively over the years, but it was still unknown that MTHFD2 was even functional in these cells.”

The researchers from Mount Sinai and Goethe University predicted and validated in follow-up experiments that the MTHFD2 gene plays a key role in endothelial cell response to oxidized phospholipids. They found that MTHFD2 was also activated in endothelial cells in response to other factors, such as inflammation or a change in amino acid concentration. This underscores the many factors involved in the development of atherosclerosis that must be understood and taken into consideration when approaching disease therapies.

“Our study showed that when the MTHFD2 gene is activated in endothelial cells in response to oxidized lipids, it sends out molecular ‘danger signals’ promoting inflammation and stimulating the atherosclerotic process,” says Ralf Brandes, MD, Director of the Institute for Cardiovascular Physiology and Professor of Physiology at Goethe University. “These findings suggest that MTHFD2 could be a novel target to disrupt development and progression of atherosclerosis.”

While the role of MTHFD2 in the vascular system was unknown before this study, the gene is known to be consistently activated in cancer, making it a promising target for cancer therapies. In clinical trials, MTHFD2 inhibitors are already in use as anticancer therapies. “It’s possible that these therapies could also help prevent coronary artery disease, but more research into the specific role of MTHFD2 in atherosclerosis is needed first, before proposing it as a target for potential therapy,” according to Dr. Zhu.

Wholeness of Life Awards for Compassionate Care

Updated on Jun 30, 2022 | Community, Featured

The Mount Sinai staff members honored were, from left, Raymond V. Wedderburn, MD; Lindsay Condrat, RN, MSN, ACNP-BC; and Junior Corniel.

Three Mount Sinai Health System employees received 2018 Wholeness of Life Awards from the HealthCare Chaplaincy Network™ for their commitment to providing compassionate and respectful care to patients. The staff members, all nominated by their colleagues, received their awards in November at the HealthCare Chaplaincy Network’s annual gala at the Lotte New York Palace.

Raymond V. Wedderburn, MD, FACS, Chief of Trauma and Critical Care at Mount Sinai St. Luke’s and Mount Sinai West, and Assistant Professor of Surgery, Icahn School of Medicine at Mount Sinai, was honored for being a gifted teacher and healer whose care for patients integrates mind, body, and spirit.

Lindsay Condrat, RN, MSN, ACNP-BC,Associate Director of Nursing, Mount Sinai Heart, was recognized for her personalized and holistic approach, especially in caring for patients who are far from home and families who are going through a difficult time.

Junior Corniel, an X-ray technician at Mount Sinai Beth Israel, was honored as an exceptionally empathic worker whose “love for his job and patients alike shines through every day.”

The HealthCare Chaplaincy Network is a global, nonprofit organization that offers spiritual care-related information and resources to hospitals and health care institutions.

STAT Online: Virtual Repurposing Can Speed the Discovery of New Uses for Existing Drugs

Updated on Jun 30, 2022 | Featured, Research

Inga Peter, PhD

In an essay in STAT, a leading online publication covering the life science industry, Inga Peter, PhD, Professor, Genetics and Genomic Sciences, at the Icahn School of Medicine at Mount Sinai, writes about a new approach to drug discovery—sometimes called virtual repurposing—that offers a way to discover unknown connections between “unconnected” diseases that may lead to new treatments.

Dr. Peter is a genetic epidemiologist with extensive experience designing studies aimed at identifying genetic risk factors associated with complex diseases such as type 2 diabetes, obesity, cardiovascular disease, and Crohn’s disease.

Read the essay in STAT online

Learn more about the Peter Laboratory at the Icahn School of Medicine